Thursday, March 30, 2017

Patient Beware!

I was going to write this when I was still angry. Angry isn't the right word. Maybe the correct word is incredulous. 

I'm sure my story is not unique, which makes me even sadder.

As you know, my husband has multiple health conditions that require seeing several doctors somewhat frequently. He sees an endocrinologist for diabetes, a neurologist for seizures and Alzheimer's, and a Primary Care Doctor. 

It is glaringly clear that patients need a tenacious advocate for medical care. It is infuriating. At our doctor's request, we scheduled a 30-minute appointment so that we could address in depth results from JM's seizure testing. We arrived 40 minutes early, not that we expected to be seen early...but just to make sure we weren't late. 

We were called back to the patient room while a nurse we had never met began reading questions from her computer screen. "What is keeping you from achieving your health goals?" was an actual question. What? How do you expect a person with Alzheimer's to understand that question, much less answer it? It was clear that the nurse, "nice" as she was, had not taken any time to read JM's chart. 

Our doctor had us wait in our little room for a full 15 minutes. Let me say that she did not extend her time with us. In essence, we paid for a 30-minute appointment when we only had 15 minutes.  The practice, of course, bills the appointment at the 30-minute rate.

When I was in the waiting room I heard the check in person recite a script I had not heard before. After the script, the patient was required to sign an agreement. Basically, the intake person explained what the medical practice would and would not address during this doctor visit. 

The intake person explained that a return visit was different from a "new" condition. You must state if you are here for a "new" condition or a follow-up. You are not allowed to go over more than one condition with the doctor during a single visit. Isn't that outrageous? 

It is clear that corporate medical practices do not see their patients as paying for a service. The patient is not considered a customer. Instead, the patient's insurance company is the client. The practice allows the insurance company to dictate what is allowable medical care. If the insurance company says "no", the doctor doesn't ask the patient if he/she wants a treatment. It's a foregone conclusion that what the insurance company says goes. They are paying the practice after all, right? NO!

The patient is the patient. The patient is the paying customer. The insurance company is NOT the client. The patient is the client of both the medical practice and the insurance company. It is OUR money that pays for the services. I pay insurance even when I don't use it. When I do use it, it is simply using some of the funds I've paid to them over time. 

I'm outraged for myself and my husband that today, I was reduced to negotiating (and begging) our doctor to complete a simple form that we need for insurance and additional medical services. She did not feel comfortable, she said. Really? You are comfortable telling your patients that they must make multiple appointments to address their health concerns. You are comfortable in requiring us to pay for separate appointments. You are comfortable in requiring us to miss work for multiple appointments. 

But a form? You can't fill out a form? The questions were "yes"/"no" questions. For instance: Does this person have asthma? Do they have arthritis? diabetes? dementia? She was not comfortable filling out the form. What? Every time we visit this doctor's office they print out a listing of all of the known medical issues my husband has ever had. The information is clearly available to the doctor. But she absolutely refused to fill out the form. She said that we needed to make an appointment with our Neurologist to have the form completed. Why? Because we have seen a Neurologist to diagnose Alzheimer's and treat seizures. The form did not ask any questions related to neurology. It is a general medical release. Why would I ask the Neurologist to own the responsibility for indicating if JM has arthritis or diabetes?

So here is what I see as the more critical question: If our Primary Care Doctor is not comfortable answering basic health questions about her patient, then why would I be comfortable that she is capable of being an effective medical professional on my husband's medical team? 

The customer is always right UNLESS the customer is a patient! 

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